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Men's Health Channel
Reported January 16, 2012

New Colonoscopy Device -- In Depth Doctor's Interview

Dr. George Triadafilopoulos, Gastroenterologist, Clinical Professor of Medicine at Stanford University talks about a new procedure for colonoscopy called Third Eye, which can look forwards and backwards to find polyps

Fifty thousand people die of colon cancer a year and they don’t have to?

Dr. Triadafilopoulos: Correct and a hundred and fifty thousand are being diagnosed with colon cancer per year so that’s a large number of the American population that suffer from this.

But it’s one of the most treatable if detected early?

Dr. Triadafilopoulos: It is one of the most treatable or to say curable cancer and more importantly it’s a preventable cancer. And that I think is very much of significance here in this discussion.

And the key is colonoscopy?

Dr. Triadafilopoulos: The key is colonoscopy, the key is to find out if you have the predisposition to colon cancer. That predisposition is called a colon polyp which is a little growth almost like a small mushroom that grows inside the intestine. If we look for those growths at an earlier stage before they become cancerous we can remove them during the exact same procedure, the colonoscopy. Eliminate them and therefore eliminate the risk of cancer.

Do all polyps become cancer if they’re not eliminated?

Dr. Triadafilopoulos: Not necessarily so not all polyps become cancerous but if they stay there long enough they eventually deteriorate. So the earlier you pick them up and you remove them the better you are in terms of preventing colon cancer.

So after fifty you’re supposed to be getting colonoscopies?

Dr. Triadafilopoulos: All the societies in the field of gastroenterology as well as cancer medicine recommend the colonoscopy at the age of fifty for everybody. Men and women of any ethnicity and race should have that.

But colonscopies there’s some downfalls?

Dr. Triadafilopoulos: Actually if it’s done by a professional who is well qualified to do the procedure it is a very safe intervention. Thousands and thousands of them are done every day in the United States and the world over so it’s a very safe procedure, the risk of less than one to two per thousand of something to go wrong so it’s a very safe procedure.

Safe but sometimes there’s a higher missed rate?

Dr. Triadafilopoulos: The issue of the colonoscopy is that it’s not perfect all the time and there are certain imperfections in the issue of colonoscopy. The imperfection that we face most commonly is a poor preparation. So if the patient is supposed to have a colonoscopy they are supposed to drink something the night before that will make them go to the bathroom and empty their bowels so when we look inside the bowel the bowel is clean. If that preparation is not adequate then the quality of the examination is inferior to what it should be and therefore inadequate. Another limitation of colonoscopy is that sometimes the small polyps grow behind a fold in the intestine and they are not visualized at the time of the examination. The examination is like looking through a tunnel and as you look through the tunnel you only look forward and as you remove the colonoscope and you go backwards and you may miss the things that are hiding behind folds. And therefore we have this new technology called third eye that allows us to look backwards as well as forward as we come out doing the examination. Therefore increasing the yield of detecting these polyps.

How long is the intestine that you have to go through?

Dr. Triadafilopoulos: About three and a half feet.

And that’s a lot of folds in there?

Dr. Triadafilopoulos: That’s a lot of folds because almost every inch or two inches there is a fold that you basically face in a normal colon.

What makes third eye different?

Dr. Triadafilopoulos: third eye is a special device that allows us to examine the bowel by looking backwards almost like having a rearview mirror on your bike or on your car. So as you drive forward or as you drive the colonoscope you can actually look through the mirror and you can actually see what happens behind you and you don’t really miss any spots behind the car for example.

How many colonoscopies do you do a day?

Dr. Triadafilopoulos: Approximately ten.

How long have you been doing colonoscopies?

Dr. Triadafilopoulos: For thirty years.

When you first used this third eye what was that like for you?

Dr. Triadafilopoulos: It was very exciting of course because I was the first to use it ever so it was a very exciting time. But we realized over the course of the years, over the past ten years at least we recognized that colonoscopy has its inadequacies and we can miss polyps. When we came up with the third eye and we started using it in several studies we found out how much we thought we were missing is now picked up by the third eye which is a very significant innovation here.

What’s the difference?

Dr. Triadafilopoulos: The difference is depending on the study and depending on the particular patient population it can go anywhere between five and forty percent so that’s a significant difference. Of polyp detection that is better with the third eye than without the third eye. So as we’re looking for polyps we think that we’ve gotten a good look and yet if we were to use the third eye we realized that we have missed on the average about twenty percent of polyps. So if we are going to do a colonoscopy it’s best to do it with the help of a third eye thereby increasing to a max, hopefully max level, the quality of the examination so we do it only once instead of bringing the patient back more frequently to make sure that everything is okay.

Would the patient know any difference between the third eye and the normal colonoscopy?

Dr. Triadafilopoulos: Not at all it does not matter to the patient they don’t feel any different. It’s just a matter of using this additional tool that attaches to the colonoscope that allows us to look backward. Again it’s the same thing as driving the car, you add the mirror or you drive the car without the mirror.

Did you develop this?

Dr. Triadafilopoulos: Not personally but a lot of smart engineers did. We did the help the development and the clinical implementation.

Did you see a need?

Dr. Triadafilopoulos: We saw a need for that very early on.

This is all covered by Medicare then?

Dr. Triadafilopoulos: It is covered by Medicare and it is covered by some insurers I think.

Do you have to ask for this or is this something that doctors will just go ahead and use?

Dr. Triadafilopoulos: If the doctor is using it in their practice then it is almost guaranteed that they will use it. Not all the physicians are using it as yet.


END OF INTERVIEW

This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.

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